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One-stage versus two-stage reimplantation: review, indication, treatment and surgical techniques

Publication at First Faculty of Medicine, Second Faculty of Medicine, Faculty of Pharmacy in Hradec Králové |
2023

Abstract

Prosthetic joint infection (PJI) represents a serious medical problem. The annual patients mortality who undergo surgical treatment for PJI varies between 8-25,9%.

Operative treatment of PJI can be divided into replacement of articulation components - DAIR (debridement, antibiotics and implant retention), complete replacement - reimplantation (one or two-stage) and simple prosthesis extraction. It can be stated that one- and two-stage reimplantation have simile clinical results but we must strictly adhere to certain indication criteria.

For one-stage reimplantation it is the isolation of a pathogenic microorganism before surgery with sensitivity, the absence of systemic sepsis, a non-immunocompromised patient. It is necessary to realize that two-stage reimplantation can no longer be called the "golden standard", but each of the techniques has its representation in a given indication scheme, and the best results can only be achieved by strictly following these criteria.